Natural factors which improve symptoms of NVP

39.   NATURAL FACTORS WHICH IMPROVE SYMPTOMS OF NVP

 

1.   Lying down early during an episode of NVP. Stated by 28/44, 63% of women. (23) Eating crackers. 23/44, 52% of women. 78 women in study. (23)

2.   From 147 women:
Eating. 52.8% (every two hours, bland carbohydrate foods, rice cakes, crackers, toast, baked potatoes, macaroni).

         Recumbent rest. 25%  

         Nothing. 9.7%

         Vomiting. 5.6% (54)

3.   51% of 363 women stated in their prospective diaries that eating improved their symptoms. (Gadsby - not published).

4.   52% of 1,000 women who were nauseated reported that eating improved their symptoms while 33% of these women who vomited said that eating improved their symptoms (40)

5.   When they are hungry they want to eat right now! 30 minutes can make the difference between a patient’s eating and becoming nauseated.

         Minimising odours is key to controlling NVP.

         Reassure patients they are not unique or strange.
Food - let women have their cravings. Potato crisps settle the stomach and drive a thirst. Patients often want cold, tart or sweet drinks, e.g. lemonade. After crisps women can eat a better meal. (70)

6.   As soon as they are hungry they should be encouraged to eat frequent small amounts of whichever food appeals to them. Emphasis on intake rather than content. (92)

7.   Suggestions of foods which appeal to pregnant women because of taste and texture:

         Salty - crisps and pretzel

         Tart/sour - pickles, lemonade

         Earthy - brown rice, mushroom soup

         Bland - mashed potatoes

         Soft - bread, noodles

         Sweet - cake, sugary cereal

         Fruity - juices, fruity popsicles

         Wet - juice seltzer

         Dry - crackers

         Crunchy - celery sticks, apples. (72)

8.   No attempt should be made to eat according to normal mealtimes. Rather the patient should be encouraged to take whatever food seems acceptable as the desire arises. (74)

9.   The majority of women, 571 (94%), had tried one or more comfort measures/medication to try to relieve their symptoms. Women used a change of dietary behaviours, most frequently (63%) - this involved experimenting with and making changes to diet, changes included small frequent meals, eating less fried and fatty meals, minimising time spent in the kitchen, eating bland foods, avoiding odours that trigger nausea and eating a dry biscuit before rising in the morning. Sucking sweets.

 

         Other measures taken to relieve NVP

        

Ginger, relaxation, naturopath

42%

 

Resting

39%

 

Vitamin B6

23%

 

Use of anti-emetics (Maxolon the most widely used)

26%

(81)

10.   Rest, preferably recumbent position, especially after meals. Fresh air. Bland food, water. Silence. Some women reported they were unable to tolerate prenatal vitamin preparations or coffee. Several participants notes nothing helps. 124 women returned clinical diaries. (108)

11.   Eating. 62% reported relief of nausea with eating.

         Resting. Lying or sitting down.

         Eating crackers or toast.

         Small frequent meals.

         38% of the time “nothing worked”. (109)

         19 women in study. Each kept record of nausea for seven days.

12.   Effective self-care actions to reduce morning sickness. Number of subjects reporting “used, helped” (n=37):

Getting more rest

27 = 73%

Eating several small meals per day

24 = 69%

Avoid bad smells

21 = 57%

Avoiding greasy or fried foods

21 = 57%

Avoiding cooking

19 = 51%

Receiving extra attention from partner

19 = 51%

Eating when feeling nauseous

16 = 43%

Keeping myself busy

16 = 43%

Sharing experiences with another mother

13 = 35%

Eating bland foods, e.g. baked potato, hot cereal

13 = 35%

Eating dry toast or crackers before getting up in the morning

11 = 30%

Cutting down on drinks of caffeine (Cola, tea, coffee)

9 = 24%

Having someone tell me that morning sickness is normal and will go away

 7 = 19%

        

         55 women in study, 37 experienced NVP. (102)

13.   Interventions used by women to alleviate NVP.

         Most of the five hundred in the study assessed themselves as having moderate to severe NVP. The three most important features for alleviation of symptoms were rest, getting fresh air and taking frequent small snacks. Emotional support from partner, family, friends etc…. and eating food were in the top five items to afford some relief. Only 30% of women took medication, but when taken medication, was the second most helpful item to relieve symptoms. (114)

14.   ‘I like to get outside to breathe the fresh air’

         ‘I sat on the front door step to get the fresh air’

                     (personal communications to Barnie-Adshead).

15.   Of 162 respondents n=55 (34%) stated nothing helpful.

         A total of 110 (39%) did mention a coping strategy.

Eating small meals

n 66 (60%)

Eating certain food

n 66 (60%)

Dry biscuits

n 16 (14%)

Sweets - mints

n 13 (12%)

Ginger biscuits

n 11 (10%)

Drinks

n 31 (28%)

Water

n 12 (11%)

Fizzy drinks

n 7 ( 6%)

Other strategies;

 

Rest, sleep, relaxation

n 21 (19%)

Fresh air, drugs, Gaviscon acupressure (combined category)

n 9 ( 8%)

 

Women reported a variety of strategies to assist NVP relief but those appear to be individualistic in nature. (141)

 

Summary

 

1.   Eating as soon as nausea stops or when feeling hungry or when feeling nauseous.

         (23) (54) Gadsby (40) (70) (92) (74) (109) (102) (114) (141)

                                                                                              Eleven References

 

2.   Nausea improved after eating. 8 references containing 2254 with NVP

         (23) (54) Gadsby (40) (81) (109) (102) (141)      1248 nausea better after food  = 55%

 

3.   Frequent small meals. (23) (54) (92) (81) (109) (102) (114) (141)

                                                                                                Eight References

 

4.   Nausea improved after eating small frequent meals in 61% of women with NVP.
 962 women with NVP, 582 women NVP improved
(23) (54) (81) (102) (109) (141)                                              Six References

 

5.   Getting more rest. (23) (54) (81) (102) (108) (109) (114) (141)

                                                                                                Eight References

 

6.   Lying down positional changes avoided especially after meals or during an episode of nausea. (23) (54) (81) (108) (109)                                                                      Five References

 

 7.   Getting fresh air. (23) (108) (114) (Barnie-Adshead) (141)   Five References

 

8.   Minimise odours. (70) (81) (108) (102)                             Four References

 

9.   Nothing helps. (54) (108) (109) (141)                               Four References

 

10.   Let them have their cravings, intake rather than content. (70) (92) (74)

                                                                                                Three References

 

11.            Medication. (81) (141)                                            Two References

 

12.   Ginger. (81) (141)                                                            Two References

 

13.   Reassure them they are not unique or strange.  (70)      One Reference

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